[Congressional Record Volume 142, Number 66 (Monday, May 13, 1996)]
[Senate]
[Pages S4974-S4975]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SIMPSON (by request):
  S. 1748. A bill to permit the Secretary of Veterans Affairs to 
reorganize the Veterans Health Administration notwithstanding the 
notice and wait requirements of section 510 of title 38, United States 
Code, and to amend title 38, United States Code, to facilitate the 
organization of the headquarters of the Veterans Health Administration; 
to the Committee on Veterans' Affairs.


                         VETERANS' LEGISLATION

 Mr. SIMPSON. Mr. President, as chairman of the Veterans' 
Affairs Committee, I have today introduced, at the request of the 
Secretary of Veterans Affairs, S. 1748, a bill to facilitate the 
reorganization of the headquarters of the Veterans Health 
Administration [VHA], Department of Veterans Affairs. The Secretary of 
Veterans Affairs submitted this legislation to the President of the 
Senate by letter dated June 22, 1995. That letter was referred to the 
Committee on Veterans' Affairs on July 20, 1995.
  This measure, Mr. President, also requests that the Congress 
authorize a VHA reorganization notwithstanding the notice and wait 
provisions of section 510 of title 38, United States Code. By the time 
that this request had been referred to the Committee on Veterans' 
Affairs, July 20, 1995, the waiting period specified under section 510 
of title 38, United States Code, had nearly expired and, thus, those 
provisions were, for practical purposes, moot at the time the committee 
received this request. Nonetheless, I have introduced this bill in its 
entirety today since it contains provisions which are not related 
directly to the reorganization which is now being implemented.
  My introduction of this measure is in keeping with the policy which I 
have adopted of generally introducing--so that there will be specific 
bills to which my colleagues and others may direct their attention and 
comments--all Administration-proposed draft legislation referred to the 
Veterans' Affairs Committee. Thus, I reserve the right to support or 
oppose the provisions of, as well as any amendment to, this 
legislation.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record, together with the transmittal letter and the 
enclosed analysis of the draft legislation.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1748

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled, That 
     except as otherwise expressly provided, whenever in this Act 
     an amendment is expressed in terms of an amendment to a 
     section or other provision, the reference shall be considered 
     to be made to a section or other provision of title 38, 
     United States Code.
       Sec. 2. (a) The Secretary of Veterans Affairs may proceed 
     with the reorganization described in subsection (b) of this 
     section without regard to section 510 of title 38, United 
     States Code.
       (b) The administrative reorganization referred to in 
     subsection (a) is the reorganization of the Veterans Health 
     Administration of the Department of Veterans Affairs as that 
     reorganization and related activity are described in a letter 
     dated March 17, 1995, and the detailed plan and justification 
     enclosed therewith, submitted by the Secretary to the 
     Committees on Veterans' Affairs of the Senate and the House 
     of Representatives pursuant to section 510 of title 38, 
     United States Code.
       Sec. 3. Section 7305 is amended to read as follows:
       ``The Veterans Health Administration shall include the 
     Office of the Under Secretary for Health and such 
     professional and auxiliary services as the Secretary may find 
     to be necessary to carry out the functions of the 
     Administration.''.
       Sec. 4. Section 7306 is amended--
       (a) in subsection (a)--
       (1) by striking ``and who shall be a qualified doctor of 
     medicine'' in paragraph (2);
       (2) by striking paragraphs (5) and (6) and redesignating 
     paragraphs (7), (8), and (9) as paragraphs (5), (6), and (7).
       (b) by amending subsection (b) to read as follows:
       ``(b) Of the Assistant Under Secretaries for Health 
     appointed under subsection (a)(3), not more than two may be 
     persons qualified in the administration of health services 
     who are not doctors of medicine, dental surgery, or dental 
     medicines.''.
                                                                    ____



                            The Secretary of Veterans Affairs,

                                        Washington, June 22, 1995.
     Hon. Al Gore,
     President of the Senate, Washington, DC.
       Dear Mr. President: There is transmitted herewith a draft 
     bill, ``To permit the Secretary of Veterans Affairs to 
     reorganize the Veterans Health Administration notwithstanding 
     the notice and wait requirements of section 510 of title 38, 
     United States Code, and to amend title 38, United States 
     Code, to facilitate the reorganization of the headquarters of 
     the Veterans Health Administration.'' We request that it be 
     referred to the appropriate committee for prompt 
     consideration and enactment.
       The draft bill contains several provisions intended to 
     assist VA in its reorganization of the Veterans Health 
     Administration (VHA). The first provision would waive the 
     waiting period otherwise required by 38 U.S.C. Sec. 510 for 
     the planned VHA reorganization which the Department reported 
     to its oversight committees on March 17, 1995. Enactment 
     would permit the Department to begin implementing the 
     reorganization immediately, and would assist the Under 
     Secretary for Health to more rapidly achieve the improvements 
     and advantages of that plan, as discussed extensively in our 
     report. By sending a signal of Congressional support for this 
     new direction for the VA health-care system, enactment would 
     give strong impetus to implementation of the plan, and would 
     assist the Under Secretary to achieve the ``culture change'' 
     within VHA which is essential to fully realize its benefits.
       The other provisions in the draft bill are aimed at 
     facilitating the reorganization of VHA's headquarters. The 
     current centralized management model for VHA, which is in 
     part required by statute, impedes the system's ability to 
     adapt to the rapidly changing health-care environment. The 
     statutory structure limits the Department's flexibility to 
     establish functions and offices in the 
     organizational structure that are most necessary, and that 
     are located in the geographic setting that best supports 
     the goals of the health-care system.
       To enhance organizational flexibility in VHA headquarters, 
     the draft bill would eliminate the statutory requirement that 
     VHA have a centralized Medical Service, Dental Service, 
     Podiatric Service, Optometric Service, and Nursing Service. 
     It would also eliminate a legal requirement that VHA have 
     Directors for each of those services. The bill would 
     additionally eliminate statutory requirements that VHA have 
     an Assistant Under Secretary for Health who is a dentist, and 
     an Assistant Under Secretary for Health with expertise and 
     training in geriatrics. The Department does not plan to 
     eliminate the functions of those offices and positions. 
     Rather, the Department seeks the flexibility to determine 
     which office and which position in the organization can best 
     provide management direction to assure that those functions 
     are appropriately carried out.
       As a final matter, the draft bill would eliminate the 
     requirement that the Associate Deputy Under Secretary for 
     Health be a doctor of medicine. That change would provide the 
     Veterans Health Administration with greater management 
     flexibility by allowing the appointment to that position of 
     an individual whose training and experience may be primarily 
     in management, budgeting, or some other administrative area, 
     rather than in medicine.
       The Office of Management and Budget advises that there is 
     no objection from the standpoint of the Administration's 
     program to the submission of this legislative proposal to the 
     Congress.
           Sincerely yours,
     Jesse Brown.
                                                                    ____


                      Section-by-Section Analysis

       Section 2 would waive the notice and wait requirements of 
     38 U.S.C. Sec. 510 with respect

[[Page S4975]]

     to an administrative reorganization of the Veterans Health 
     Administration. The reorganization is one described in a 
     letter dated March 17, 1995, and the detailed plan and 
     justification enclosed therewith, submitted by the Secretary 
     to the Committees on Veterans' Affairs of the Senate and the 
     House of Representatives pursuant to section 510 of title 38, 
     United States Code.
       Section 3 would amend 38 U.S.C. Sec. 7305 to delete the 
     current statutory requirement that the Veterans Health 
     Administration include a centralized Medical Service, Dental 
     Service, Podiatric Service, Optometric Service, and Nursing 
     Service. It would provide the Administration with greater 
     flexibility to provide the functions those services now 
     provide in the most appropriate setting and geographic 
     location.
       Section 4 would amend 38 U.S.C. Sec. 7306. It would first 
     eliminate the legal requirement that the Veterans Health 
     Administration have Directors for each of the services 
     deleted from 38 U.S.C. Sec. 7305 by section 3 of the draft 
     bill. Section 4 would also eliminate a requirement in section 
     7306 that the Veterans Health Administration have an 
     Assistant Under Secretary for Health who is a dentist, and an 
     Assistant Under Secretary for Health with expertise and 
     training in geriatrics. Finally, section 4 would delete the 
     requirement in section 7306 that the Associate Deputy Under 
     Secretary for Health be a doctor of medicine. The proposed 
     amendments would all facilitate reorganization of the 
     headquarters of the Veterans Health Administration.
                                 ______